Charter for Health Care Workers
Pontifical Council for Pastoral Assistance

Endnotes

1. John Paul II, during his
visit to Mercy Maternity Hospital in Melbourne, Nov.
28, 1986, in Insegnamenti IX/2 (1986) 1734,
n. 5. "Life and physical health are precious gifts
entrusted to us by God. We must take reasonable care
of them, taking into account the needs of others and
the common good" (CCC 2288).

2. John Paul II, To the
participants at two congresses of medicine and
surgery, Oct. 27, 1980, in Insegnamenti
III/2, p. 1010, n. 6.

3. "In exercising your
profession, you are always dealing with the human
person, who entrusts his body to you, confident of
your competence as well as your solicitude and
concern. It is the mysterious and wonderful reality
of the life of a human being, with his suffering and
his hope, that you are dealing with." John Paul II,
To the participants at a surgery congress,
Feb. 19, 1987, in Insegnamenti X/1 (1987)
374, n. 2.

4. Cf. John Paul II, To the
participants at a medical congress on tumor therapy,
Feb. 25, 1982 in Insegnamenti V/1, 698. Cf.
also John Paul II: "None of you can be merely a
doctor of an organ or an apparatus, but you must
look to the whole person," To the World Congress
of Catholic Doctors, Oct. 3, 1982, in Insegnamenti V/3, pp. 673-674, n. 4.

6. John Paul II, Motu Proprio "Dolentium
hominum," Feb. 11,1985, in Insegnamenti
VIII/1, p. 474, n. 2. "Care for the health of its
citizens requires that society help in the
attainment of living conditions that allow them to
grow and reach maturity: food and clothing, housing,
health care, basic education, employment, and social
assistance" (CCC 2288).

7. John Paul II, To the
participants at a medical congress on tumor therapy,
Feb. 25, 1982, in Insegnamenti V/1, p. 698,
n. 4. Cf. To the participants at a scientific
congress, May 21, 1982, in Insegnamenti
V/2, p. 1792, n. 5.

8. "As I have said many times
in my meetings with health care workers, your
vocation is one which commits you to the noble
mission of service to people in the vast, complex
and mysterious field of suffering" John Paul II, To representatives of the Italian Catholic Doctors,
March 4,1989, in Insegnamenti XII/1, p. 480,
n. 2.)

9. John Paul II, To the
Association of Italian Catholic Doctors, Dec.
28. 1978, in Insegnamenti I, p. 436. "You are
aware of the close relationship, the analogy, the
interaction between the mission of the priest on the
one hand and that of the health care worker on the
other: all are devoted, in different ways, to the
salvation of the person, and care for his health, to
free him from illness, suffering and death, to
promote in him life well-being and happiness" (John
Paul II, "Discourse for the 120th anniversary of
the foundation of the 'Bambin Gesu' hospital,"
March 18, 1989, in Insegnamenti XII/1,
605-608, n. 2).

10. Cf. John Paul II, Apost.
Letter Salvifici doloris, in Insegnamenti
VII/1, 353-358, nn. 28-30; To an international
group of scientists, April 27, 1984, in Insegnamenti VII/1, 1133-1135, n. 2:
To the
Catholic health organizations of the United States,
Sept. 14, 1987, in Insegnamenti X/3 (1987)
506.

11. "The very personal
relationship of dialogue and trust established
between you and the patient requires of you a level
of humanity which, for the believer, is found in the
richness of Christian charity. This is the divine
virtue which enriches all your actions and gives to
your gestures, even the simplest of them, the power
of an act performed by you in inner communion with
Christ": John Paul II To the Association of
Dental Doctors, Dec. 14, 1984, in Insegnamenti VII/2, 1592-1594, n. 4. "You bring
to the sick-room and to the operating table
something of God's charity, of the love and
tenderness of Christ, the great Doctor of the soul
and the body": John Paul II, To the
'Fatebenefratelli' hospital, April 5, 1981, in
Insegnamenti IV/1, p. 895, n. 3.

12. Cf. John Paul II, To the
'Armida Barelli' training school for professional
nurses, May 27, 1989, in Insegnamenti
XII/1, p. 1364, n. 3. "What a stimulus for the
desired 'personalization' of medicine could come
from Christian charity, which makes it possible to
see in the features of every sick person the
adorable face of the great, mysterious Patient, who
continues to suffer in those over whom your
profession bends, wisely and providently!" (John
Paul II, To the participants at two congresses of
medicine and surgery, Oct. 27, 1980, in Insegnamenti III/2, p. 1010, n. 7).

19. "Every concern for illness
and suffering is part of the life and the mission of
the Church" (John Paul II, To the Catholic health
organizations of the United States of America,
Sept. 14, 1987, in Insegnamenti X/3 [1987]
502-503, n. 3). "Allowing herself to be guided by
the example of Jesus the 'Good Samaritan' (cf. Lk
10:2937) and upheld by his strength, the Church has
always been in the front line in providing
charitable help: so many of her sons and daughters,
especially men and women religious, in traditional
and ever new forms, have consecrated and continue to
consecrate their lives to God, freely giving of
themselves out of love for their neighbor,
especially for the weak and needy" (John Paul II,
Encyclical Evangelium vitae, March 25, 1995,
n. 27).

20. Cf. John Paul II, To the
world Congress of Catholic doctors, Oct. 3 1982,
in Insegnamenti V/3, p. 676, n. 3. "The Lord
Jesus Christ physician of our souls and bodies, who
forgave the sins of the paralytic and restored him
to bodily health, has willed that his Church
continue, in the power of the Holy Spirit, his work
of healing and salvation even among her own members.
This is the purpose of the two sacraments of
healing: the sacrament of Penance and the sacrament
of Anointing of the Sick (CCC 1421).

21. "Your presence at the
sick-bed is bound up with that of those-priests,
religious and laity-who are engaged in apostolate to
the sick. Quite a number of the aspects of that
apostolate coincide with the problems and tasks of
the service to life rendered by medicine. There is a
necessary interaction between the exercise of the
medical profession and pastoral work, because the
one object of both is the human person, seen in his
dignity of a child of God, a brother or sister
needing, just like ourselves, help and comforting"
(John Paul II, To the World Congress of Catholic
Doctors, Oct. 3 1982, in Insegnamenti
V/3, p. 676, n. 6).

22. "You, while you alleviate
sufferings and try to cure them, at the same time
are witnesses of the Christian view of suffering and
of the meaning of life and death, in the way it is
taught by your Christian faith" (John Paul II, To
the Catholic Health Organizations of the United
States of America, Sept. 14, 1987, in Insegnamenti
X/3 [1987] pp. 502 and 505.)

24. Cf. John Paul II, To the
participants at the International Congress for
Assistance to the Dying, in Oss. Rom. March 18,
1992, n. 6. "Every individual, precisely by reason
of the mystery of the Word of God who was made flesh
(cf. Jn 1: 14), is entrusted to the maternal care of
the Church" John Paul II, Encyclical Evangelium
vitae, March 25, 1995, n. 3).

25. John Paul II, To the
participants at a surgery congress, Feb. 19,1987
in Insegnamenti X/1, p. 375, n. 3. "The
advance of science and technology, this splendid
witness of the human capacity for understanding and
for perseverance, does not dispense humanity from
the obligation to ask the ultimate religious
questions. Rather it spurs us on to face the most
painful and decisive of struggles, those of the
heart and of the moral conscience" John Paul II,
Encyclical Veritatis splendor, n. 1).

26. Cf. John Paul II, Motu
Proprio Dolentium hominum, Feb. 11, 1985, in
Insegnamenti VIII/1 (1985) p. 475.
"Especially significant is the reawakening of an
ethical reflection on issues affecting life. The
emergence and ever more widespread development of
bioethics is promoting more reflection and
dialogue-between believers and non-believers, as
well as between followers of different religions-on
ethical problems, including fundamental issues
pertaining to human life" (John Paul II, Encyclical
Evangelium vitae, March 25, 1995, n. 27).

27. Cf. John Paul II, To the
Association of Catholic health care workers,
Oct. 24, 1986, in Insegnamenti IX/2, p. 1171,
n. 3. "In today's cultural and social context, in
which science and the practice of medicine risk
losing sight of their inherent ethical dimension,
health-care professionals can be strongly tempted at
times to become manipulators of life, or even agents
of death" John Paul II Encyclical Evangelium
vitae, March 25, 1995, n. 89).

28. Synod of Bishops, special
Assembly for Europe, Concluding Statement, in
Oss. Rom. Dec. 20, 1991, n. 10. "It is
illusory to claim that scientific research and its
applications are morally neutral. On the other hand,
guiding criteria cannot be deduced from merely
technical efficacy, nor from the usefulness to some
to the detriment of others, nor, worse still, from
the dominant ideologies. Science and technology
require, by their very inner significance,
unconditional respect for the fundamental criteria
of morality; they must be at the service of the
human person, of his inalienable rights, of his true
and integral good, in conformity with God's plan and
will" Cong. Doct. Faith, Instruct. Donum vitae,
Feb. 22, 1987, in AAS 80 (1988) Introduction, 2, p.
73 (cf. CCC 2294).

29. Ethical committees,
composed of specialists in the medical and moral
nerds, are also established by governments, which
give them consultative and supervisory roles. "The
Church is aware that the issue of morality is one
which deeply touches every person; it involves all
people, even those who do not know Christ and his
Gospel or God himself. She knows that it is
precisely <on the path of the moral life that the
way of salvation is open to all>" John Paul II,
Encyclical Veritatis splendor, n. 3. "...No
darkness of error or of sin can totally extinguish
in the human person the light of God the Creator. In
the depths of his heart there always remains a
yearning for absolute truth and a thirst to attain
full knowledge of it. This is eloquently proved by
man's tireless research in all fields and in every
sector. His search for the meaning of life proves it
even more (ibid., n. 1). Cf. John Paul II,
Encyclical Evangelium vitae, March 25, 1995.
n. 4.

30. Cf. John Paul II, To the
plenary assembly of the Pontifical Council for
Pastoral Assistance to Health Care Workers, Feb.
9,1990, in Insegnamenti XIII/2, p. 405, n. 4.

32. Cf. To scientists and
health care workers, Nov. 12, 1987, in Insegnamenti
X/3 (1987) 1088: "The humanization
of medicine is a duty of justice, and its
implementation cannot be entirely delegated to
others, since it requires the commitment of all. Its
operative field is very vast: it goes from health
education to the creation of greater sensitivity in
those in public authority; from direct involvement
in one's own workplace to forms of
cooperation-local, national and international-which
are made possible by the existence of so many
organizations and associations which have among
their purposes the call, direct or indirect, for a
need to make medicine ever more human."

35. John Paul II, To the
World Medical Association, Oct. 29, 1983, in Insegnamenti
VI/2, 921. Cf. Allocution to the
participants at a congress of the Pontifical Academy
of Sciences, Oct. 23, 1982, in Insegnamenti
V/3, 895-898.

37. John Paul II, To the
Union of Italian Jurists, Dec. 5, 1987, in Insegnamenti
X/3, (1987) 1295. "The Church
remains deeply conscious of her 'duty in every age
of examining the signs of the times and interpreting
them in the light of the Gospel, so that she can
offer in a manner appropriate to each generation
replies to the continual human questionings on the
meaning of this life and the life to come and on how
they are related"' (John Paul II, Encyclical Veritatis splendor, n. 2).

44. "The inner structure of the
marriage act is such that, while it profoundly
unites the partners, it fits them for the generation
of new life, according to laws inscribed in the very
being of the man and the woman" (Paul VI, Encyclical
Humanae vitae, in AAS 60 [1968] pp. 488-489,
n. 12).

46. Cf. Paul VI, Encyclical Humanae vitae, n. 12; John Paul II, Apostol.
Exhort. Familiaris consortio, in AAS 74
(1982) p. 118, n. 32. "Consequently, 'the one who
wishes to understand himself thoroughly-and not just
in accordance with immediate, partial, often
superficial, and even illusory standards and
measures of being-must with his unrest, uncertainty
and even his weakness and sinfulness, with his life
and death, draw near to Christ...."' (John Paul II,
Encyclical Veritatis splendor, n. 8).

47. Natural methods "are
diagnostic means for the fertile periods of the
woman, which make it possible to refrain from sexual
relations when legitimate motives of responsibility
dictate the avoidance of conception" (John Paul II,
To the participants at a course for teachers of
natural methods, Jan. 10, 1992, in Oss. Rom.
Jan. 11, 1992, n. 3).

56. John Paul II, To the
participants at two congresses on the problems of
matrimony, the family and fertility, June 8,
1984, in Insegnamenti VII/1, 1664-1665. "On
the innate meaning which is that of mutual, total
donation by the partners, contraception imposes an
objectively contradictory meaning, namely that of
not giving oneself completely to the other" (Apost.
Exhort. Familiaris consortio, 32).

70. "Homologous FIVET takes
place outside the bodies of the partners through the
actions of third parties whose competence and
technical activity determine the success of the
intervention; it entrusts the life and identity of
the embryo to the power of doctors and biologists
and gives technology dominion over the origin and
destiny of the human person" (ibid., p. 93).

71. Cf. ibid., AAS 80 (1988)
pp. 85-86,91-92,96-97. "The origin of a human person
is really the result of a donation. The conception
should be the fruit of the love of its parents. It
cannot be desired nor conceived as the product of
the intervention of medical or biological
techniques: this would be to reduce it to becoming
the object of scientific technology. No one can
subject the arrival of a child into the world to
conditions of technical efficiency which can be
evaluated according to parameters of control and
dominion" (ibid, p. 92).

75. Cf. ibid., p. 97. "A
child is not something owed to one, but is a gift.
The 'supreme gift of marriage' is a human person. A
child may not be considered a piece of property, an
idea to which an alleged 'right to a child' would
lead. In this area, only the child possesses genuine
rights: the right 'to be the fruit of the specific
act of the conjugal love of his parents,' and 'the
right to be respected as a person from the moment of
his conception"' (CCC 2378).

76. Cf. ibid., p. 85 and
84. The "so-called 'spare embryos' are...used for
research which, under the pretext of scientific or
medical progress, in fact reduces human life to the
level of simple 'biological material' to be freely
disposed of" (John Paul II, Encyclical Evangelium
vitae, March 25, 1995, n. 14).

77. Cf. Cong. Doct. Faith,
Instruct. Donum vitae, Feb. 22, 1987, in AAS
80 (1988), p. 94. "Certainly homologous FIVET is not
burdened with all the ethical negativity which is to
be found in extra-matrimonial procreation; the
family and the marriage are still the ambient of the
birth and education of the child." However, it is at
variance with the dignity of human procreation,
depriving it of the dignity which is proper and
connatural to it.

86. Cf. John Paul II, To the
participants at the 35th General Assembly of the
World Medical Association, Oct. 29, 1983, in Insegnamenti VI/2, 917-923, AAS 76 (1984) 390];
To the Catholic health organizations of the
United States of America, Sept. 14, 1987, in Insegnamenti
X/3 (1987) 500-507; To the
participants at the VII Symposium of European
Bishops, Oct. 17, 1989, in Insegnamenti
XII/2, p. 947, n. 7.

89. Even the theory of the
fourteenth day-the day when the primitive streak
appears, in which the cells lose their
toti-potentiality and twin divisions are no longer
possible-cannot ignore and deny the fundamental and
decisive biogenetic fact of the human and individual
nature of the fruit of the conception.

96. John Paul II, To the
participants at the 35th General Assembly of the
World Medical Association, Oct. 29, 1983, in Insegnamenti VI/2, 917-923, AAS 76 (1984) 393].
"The human person, created in the image of God, is a
being at once corporeal and spiritual. The biblical
account expresses this reality in symbolic language
when it affirms that 'then the Lord God formed man
of dust from the ground, and breathed into his
nostrils the breath of life; and man became a living
being' (Gen 2:7). Man, whole and entire, is
therefore willed by God" (CCC 362).

97. Cong. Doct. Faith,
Instruct. Donum vitae, Feb. 22, 1987, in AAS
80 (1988) 74-75. "The unity of soul and body is so
profound that one has to consider the soul to be the
'form' of the body: i.e., it is because of its
spiritual soul that the body made of matter becomes
a human, living body; spirit and matter, in man, are
not two natures united, but rather their union forms
a single nature" (CCC 365).

98. Cf. John Paul II, To the
participants at the 35th General Assembly of the
World Medical Association, Oct. 29, 1983, in
Insegnamenti VI/2, 920, n. 5.

99. "The body reveals the human
being, expresses the person and is the first message
of God to the human being himself' (John Paul II,
allocutions of Jan. 9 and Feb. 20,1980, in Insegnamenti
III/1, 8895 and 428-434).

100. The moral law, in which
biological meanings take shape, "cannot be seen as a
merely biological norm" but as integrally human: in
it is expressed "the rational order according to
which the human person is called by the Creator to
direct and regulate his life and his actions and, in
particular, souse and dispose of his own body":
Cong. Doct. Faith, Instruct. Donum vitae,
Feb. 22, 1987, in AAS 80 (1988) p. 74; Paul VI,
Encyclical Humanae vitae, in AAS 60 (1968) p.
487, n. 10.

104. Cf. Pius XII, To the
participants at the Congress of Italian Catholic
Obstetricians, Oct. 29, 1951, in AAS 43 (1951)
838: John Paul II, To the participants at the
54th updating Course of the Catholic University,
Sept. 6, 1984, in Insegnamenti VII/2, p. 333.
"The human body shares in the dignity of the 'image
of God': it is a human body precisely because it is
animated by a spiritual soul, and it is the whole
human person that is intended to become, in the Body
of Christ, a temple of the Spirit" (CCC 364).

105. John Paul II, To the
participants at a congress of the "Movement for Life,"
Oct. 12, 1985, in Insegnamenti VI/2, 933-936,
n. 2. Cf To scientists and health care workers,
Nov. 12, 1987, in Insegnamenti X/3 (1987)
1084-1085, n. 2. Cf. Pius XII, To the members of
the First International Congress of Histopathology
of the Nervous System, Sept. 14, 1952, in AAS 44
(1952) p. 782.

107. John Paul II, To the
participants at a congress for obstetricians,
Jan. 26, 1980, in Insegnamenti III/1, p. 192,
n. 2; To the participants at the congress of the
Italian Association of Anesthesiology, Oct. 4,
1984, in Insegnamenti VII/2, p. 750, n. 4; To the Catholic health organizations of the United
States of America, Sept. 14, 1987, in Insegnamenti
X/3 (1987) 504.

108. John Paul II, To the
participants at a congress of the "Movement for Life,"
Oct. 12, 1985, in Insegnamenti VIII/2, pp.
933-936, n. 2.

109. John Paul II, To the
participants at the III Congress of the Association
of Catholic Health Care Workers, Oct. 24, 1986,
in Insegnamenti IX/2, p. 1172.

110. "Scientists and doctors
must not think that they are lords of life, but
rather its expert and generous servants" (John Paul
II, To the Pontifical Academy of Sciences,
Oct. 21, 1985, in Insegnamenti VIII/2, p.
1081, n. 3.

112. John Paul II, To the
participants at a congress of the "Movement for Life,"
Dec. 4, 1982, in Insegnamenti V/3, p. 1513,
n. 5, To the Pontifical Academy of Sciences,
Oct. 23, 1982, in Insegnamenti V/3, p. 896,
n. 2; To the participants at the Colloquium of
the "Nova Spes" international Foundation, Nov.
9, 1987, in Insegnamenti X/3 (1987)
1050-1051, n. 2.

118. John Paul II, Apost.
Exhort. Christifideles laici, Dec. 30, 1988,
in Insegnamenti XI/4, p. 2133, n. 38. "Man is
not the master of life, nor is he the master of
death. In life and in death, he has to entrust
himself completely to the 'good pleasure of the Most
High,' to his loving plan" (John Paul II, Encyclical
Evangelium vitae, March 25, 1995, n. 46).

119. "The doctor has only the
power and rights over the patient which the latter
gives him, either explicitly or tacitly. For his
part, the patient cannot give more rights than he
has" (Pius XII, To the members of the First
International Congress on Histopathology of the
Nervous System, Sept. 14, 1952, in AAS 44 [1952]
p. 782.)

120. "The patient is bound by
the immanent teleology established by nature. He has
the right to use-limited by the natural finality-the
faculties and powers of his human nature." (Ibid.)

127. John Paul II, Motu
Proprio "Dolentium hominum," Feb. 11, 1985,
in Insegnamenti VIII/1 (1985) pp. 473-474.
"Illness and suffering have always been among the
gravest problems confronted in human life. In
illness man experiences his powerlessness, his
limitations, and his finitude. Every illness can
make us glimpse death" (CCC 1500). "The mission of
Jesus, with the many healings he performed, shows
God's great concern even for man's bodily life"
(John Paul II, Encyclical Evangelium vitae,
March 25,1995, n. 47).

130. Cf. John Paul II, during
a visit to Mercy Maternity Hospital in Melbourne,
Nov. 28, 1986, in Insegnamenti IX/2 (1986)
1733, n. 2. "The sick too are sent as laborers into
the Lord's vineyard. The burden that tires the
members of the body and shatters the serenity of the
spins, far from deterring them from work in the
vineyard, calls them to live out their human and
Christian vocation and to share in the growth of the
Kingdom of God in new ways, which are also more
valuable" (John Paul II, Apost. Exhort. Christifideles laici, in
Insegnamenti XI/4, p. 2160, 53).

131. John Paul II, Discourse in Lourdes, August 15, 1983, n. 4 "On
the cross, Christ made his own all the weight of
evil and took away the sin of the world (Jn 1, 29),
of which sickness is but a consequence, By his
passion and death on the cross, Christ has given new
meaning to suffering: now it can configure us to him
and unite us with his redemptive passion."

133. Cf. John Paul II, To
the participants at a congress of "Movement for Life,"
Dec. 4, 1982, in Insegnamenti, V/3, p. 1512,
n. 4.

134. Cong. Doct. Faith,
Instruct. Donum vitae, Feb. 22, 1987, in AAS
80 (1988) 79-80. With regard to the diagnostic
techniques mostly used, which are echography (and
amniocentesis, it can be said that the former
appears to be risk-free whereas the latter contains
elements of risk considered acceptable and therefore
proportionate. The same cannot be said for other
techniques, such as placento centesis, fetoscopy and
the collecting of villi samples which have more or
less high levels of risk.

135. Ibid. "Prenatal
diagnosis, which presents no moral objections if
carried out in order to identify the medical
treatment which may be needed by the children the
womb, all too often becomes an opportunity for
proposing and procuring an abortion. This is eugenic
abortion, justified in public opinion on the basis
of a mentality...which accepts life only under
certain conditions and rejects it when it is
affected by any limitation, handicap or illness"
(John Paul II, Encyclical Evangelium vitae,
March 25, 1995, n. 14).

136. Cf. Cong. Doct. Faith,
Instruct. Donum vitae, Feb. 22, 1987, in AAS
80 (1988) 79-80. "Since it must be treated from
conception as a person, the embryo must be defended
in its integrity, cared for, and healed, as far as
possible. like any other human being" (CCC 2274).

138. "Every person has a
primary right to what is necessary for the care of
his or her health and therefore to suitable medical
assistance" (John Paul II, To the World Congress
of Catholic Doctors, Oct. 3, 1992, in Insegnamenti V/3, p. 673, n. 3).

140. "Even when it cannot
cure, science can and should treat and assist the
sick person" (John Paul II, To the participants
at a study course on "human pre-leukemias," Nov.
15, 1985, in Insegnamenti VIII/2, p. 1265, n.
5. Cf. John Paul II, To two work groups set up by
the Pontifical Academy of Sciences, Oct. 21,
1985, in Insegnamenti VII/2, p. 1082, n. 4.

143. "The principle of
totality states that the part exists for the whole,
and consequently that the good Of the part is
subordinated to that of the whole: that the whole is
determining for the part and it can dispose of it in
its own interests (Pius XII, To the members of
the First International Congress on Histopathology
of the Nervous System, Sept. 14, 1952, in AAS 44
[1952] p. 787).

144. Pius XII, To the
members of the XXVI Italian Congress of Urology,
Oct. 8, 1953, in AAS 45 (1953) p. 674; cf. Pius XII,
To the members of the First International
Congress on Histopathology of the Nervous System,
Sept. 14, 1952, in AAS 44 (1952) 782-783. The
principle of totality is applied at the outbreak of
the illness: there alone is verified "correctly" the
relation of the part to the whole. Cf. ibid, p. 787.
"Where the relationship of the part to the whole is
verified, and to the extent that it is verified, the
part is subordinated to the whole, which can in its
own interests dispose of the part (ibid). The
physical integrity of a person cannot be impaired to
cure an illness of psychic or spiritual origin. Here
it is not a question Of diseased or malfunctioning
organs. And so their medico-surgical manipulation is
an arbitrary alteration of the physical integrity of
the person.

It is not lawful to sacrifice to the whole, by
mutilating it, modifying it or removing it, a part
which is not pathologically related to the whole.
And this is why the principle of totality cannot be
correctly taken as a criterion for legitimatizing
anti-procreative sterilization therapeutic abortion
and transsexual medicine and surgery. It is
different with psychic sufferings and spiritual
disorders with an organic basis, that is, which
arise from a defect or physical disease: on these it
is legitimate to intervene therapeutically.

150. "The Christian is bound
to mortify the flesh and apply himself to interior
purification.... Insofar as self-control and control
of disordered tendencies cannot be acquired without
the help of physical pain, this becomes a need and
it must be accepted, but insofar as it is not
required for this purpose, it cannot be said that
there is a strict obligation for it. Hence the
Christian is never obliged to desire it; he sees it
as a more or less suitable means, according to the
circumstances, to the end he is pursuing" (Pius XII,
To an international assembly of doctors and
surgeons, Feb. 24, 1957, in AAS 49 [1957] p.
135).

156. "The patient cannot be
the object of decisions which he will not make, or,
if he is not able to do so, which he could not
approve. The "person," principally responsible for
his own life, should be the center of any assisting
intervention: others are there to help him, not to
replace him" (Pont. Coun. "Cor Unum," Some
Ethical Questions Relating to the Gravely Ill and
the Dying, July 27, 1981, in Enchiridion
Vaticanum 7, Documenti ufficiali della Santa
Sede 1980-1981. EDB, Bologna 1985, p. 1137, n.
2.1.2).

158. Cf. John Paul II, To
the participants at two congresses on medicine and
surgery, Oct. 27,1980, in Insegnamenti
III/2, 1008-1009, n. 5.

159. John Paul II, To the
representatives of the Italian Society of Medicine
and the Italian Society of General Surgery, Oct.
27, 1980, n. 3.

160. John Paul II, To the
participants at a congress on cancer, April 26,
1986, in Insegnamenti IX/1, 1152-1153.

161. Cf. John Paul II, To
scientists and health care workers, Nov. 12,
1987, in Insegnamenti X/3, (1987) 1086-1087,
n. 4. "Some abusive interpretations of scientific
research in the field of anthropology must also be
mentioned. Arguing from the great variety of
customs, behavior patterns and institutions present
in humanity these theories conclude, if not always
with the denial of universal human values, at least
with a relativist conception of morality" (John Paul
II, Encyclical Veritatis splendor, n. 33).

162. John Paul II, To the
participants at two congresses on medicine and
surgery, Oct. 27, 1980, in Insegnamenti
III/2,1009, n. 5.

163. Pius XII, To the
members of the First International Congress on
Histopathology of the Nervous System, Sept. 14,
1952, in AAS 44 (1952) p. 788.

164. John Paul II, To a
conference on pharmacy in the synod hall, Oct.
24, 1986, in Insegnamenti IX/2, p. 1183; cf.
To the participants at a surgery congress,
Feb. 19, 1987, in Insegnamenti X/1 (1987)
376, n. 4. "Research or experimentation on the human
being cannot legitimate acts that are in themselves
contrary to the dignity of persons and to the moral
law. The subjects' potential consent does not
justify such acts. Experimentation on human beings
is not morally legitimate if it exposes the
subject's life or physical and psychological
integrity to disproportionate or avoidable risks"
(CCC 2295).

165. Cf. John Paul II, To
the participants at two congresses on medicine and
surgery, Oct. 27, 1980, in Insegnamenti
III/2, 1008-1009, n. 5; To the participants at a
study course on "human pre-leukemias," Nov. 15,
1985, in Insegnamenti VIII/2, p. 1265, n. 5.

166. John Paul II, To the
participants at a meeting of the Pontifical Academy
of Sciences, Oct. 23, 1982, in Insegnamenti
V/3, p. 897, n. 4: "Therefore, the reduction in
experiments on animals, which are progressively
becoming less necessary, is in accordance with the
good of all creation" (ibid ).

167. Cf. John Paul II, To a
conference on pharmacy in the synod hall, Oct.
24, 1986, in Insegnamenti IX/2, p. 1183.

168. Cong. Doct. Faith, Declaration on Euthanasia, May 5,1980, in AAS 72
(1980) p. 550. "It may happen, in doubtful cases,
when known means have failed, that a new method, as
yet insufficiently tested, offers, together with
rather dangerous elements, a good probability of
success. If the patient consents, the application of
the procedure in question is lawful" (Pius XII, To the participants at the First International
Congress on Histopathology of the Nervous System,
Sept. 14, 1952, in AAS 44 (1952) p. 788).

173. Cong. Doct. Faith,
Instruct. Donum vitae, in AAS 80 (1988)
81-83. "This evaluation of the morality of abortion
is to be applied also to the recent forms of
intervention on human embryos which, although
carried out for purposes legitimate in themselves,
inevitably involve the killing of those embryos....
The use of human embryos or fetuses as an object of
experimentation constitutes a crime against their
dignity as human beings who have a right to the same
respect owed to a child once born, just as to every
person" (John Paul II, Encyclical Evangelium
vitae, March 25, 1995, n. 63).

174. Cf. Cong. Doct. Faith,
Instruct. Donum vitae, in AAS 80 (1988)
81-83. "I condemn in a most explicit and formal way
experimental manipulation of the human embryo,
because it is a human being; from the moment of its
conception until death it can never be
instrumentalized for any reason whatsoever" (John
Paul II, To the participants at a meeting of the
Pontifical Academy of Sciences, Oct. 25, 1982,
in AAS 75 (1983) 37). "Respect for the human being
excludes all kinds of experimental manipulation or
exploitation of the embryo" (Holy See, Charter on
the Rights of the Family, 4/b, in Oss. Rom.,
Oct. 25, 1983).

175. Cf. John Paul II, To
the participants at the First International Congress
on the Transplant of Organs, June 20, 1991, in
Insegnamenti XIV/1 (1991) 1710.

176. Ibid, "Organ transplants
are not morally acceptable if the donor or those who
legitimately speak for him have not given their
informed consent. Organ transplants conform with the
moral law and can be meritorious if the physical and
psychological dangers and risks incurred by the
donor are proportionate to the good sought for the
recipient. It is morally inadmissible directly to
bring about the disabling mutilation or death of a
human being, even in order to delay the death of
other persons" (CCC 2296).

177. Cf. Pius XII, To the
delegates of the Italian Association of Cornea
Donors and the Italian Union for the Blind, May
14, 1956, in AAS 48 (1956) 464-465; John Paul II, To the participants at the First International
Congress on the Transplant of Organs, June 20
1991, in Insegnamenti XIV/1 (1991) 1711.

178. John Paul II, To the
participants at the First International Congress on
the Transplant of Organs, June 20, 1991, in Insegnamenti XIV/1 (1991) 1711.

182. Cf. Pontifical Academy of
Sciences, Declaration on the Artificial
Prolongation of Life and Determining the Precise
Moment of Death, Oct. 21, 1985, n. 1, 3.

183. Pius XII, To the
delegates of the Italian Association of Cornea
Donors and the Italian Union for the Blind, May
14, 1956, in AAS 48 (1956) pp. 462-464.

184. John Paul II, To the
participants at the First International Congress on
the Transplant of Organs, June 20, 1991, in Insegnamenti XIV/I (1991) 1711, n. 3.

185. Ibid; cf. Pius XII, To
the delegates of the Italian Association for Cornea
Donors and the Italian Union for the Blind, May
14 1956, in AAS 48 (1956) p. 465. Cf. Pius XII, Discourses to Doctors p. 467: "In advertising
(for cornea donors) an intelligent reserve should be
maintained to avoid serious interior and exterior
conflicts. Also, is it necessary, as often happens,
to refuse any compensation as a matter of principle?
The question has arisen. Without doubt there can be
grave abuses if recompense is demanded; but it would
be an exaggeration to say that any acceptance or
requirement of recompense is immoral. The case is
analogous to that of blood transfusion; it is to the
donor's credit if he refuses recompense, but it is
not necessarily a fault to accept it."

186. Cf. John Paul II, To
the participants at the First international Congress
on the Transplant of Organs, June 20, 1991, in
Insegnamenti XIV/1 (1991) 1712.

188. Ibid., p. 1713, n. 5:
"The difficulty of the intervention, the need to act
promptly, and the need for maximum concentration on
the task, should not lead to the doctor's losing
sight of the mystery of love contained in what he is
doing."

"The different commandments of the Decalogue are
really so many reflections of the one commandment
about the good of the person, at the level of the
many different goods which characterize his identity
as a spiritual and bodily being in relationship with
God, with his neighbor and with the material world"
(John Paul II, Encyclical Veritatis splendor,
n. 13).

189. "At the root of alcohol
and drug abuse-taking into account the painful
complexity of causes and situations-there is usually
an existential vacuum, due to an absence of values
and a lack of self-esteem, of trust in others and in
life in general" (John Paul II, To the
participants at the International Conference on
Drugs and Alcohol, Nov. 23, 1991, in Insegnamenti XIV/2 (1991) 1249, n. 2.

193. Cf. John Paul II, Message to the International Congress in Vienna,
June 4, 1987, in Insegnamenti VII/2, p. 347,
n. 3.

194. John Paul II, To the
participants at the VII World Congress of
Therapeutic Communities, Sept. 7, 1984, in Insegnamenti VII/2, p. 347, n. 3.

195. John Paul II, To the
participants at the International Conference on
Drugs and Alcohol, Nov. 23, 1991, n. 4. "The use
of drugs inflicts very grave damage on human life
and health. Their use, except on strictly
therapeutic grounds, is a grave offense. Clandestine
production of and trafficking in drugs are
scandalous practices. They constitute direct
cooperation in evil, since they encourage people to
practices gravely contrary to the moral law" (CCC
2291).

196. John Paul II, To the
participants at the International Conference on
Drugs and Alcohol, Nov. 23, 1991, n. 4.

198. "The present economic
conditions in society, as well as the high level of
poverty and unemployment, can be contributary
factors that increase in your people a sense of
unrest, insecurity, frustration and social
alienation, leading them on to the illusory world of
alcohol as an escape from the problems of life":
John Paul II, To the participants at a congress
on alcoholism, in Insegnamenti VIII/1, p.
1741.

199. There are three
categories of psycho-pharmaceuticals. The first is
that of neuroleptics, the anti-psychotics which have
made possible the closing of psychiatric hospitals,
since they overcome agitation, deliria and
hallucinations, and so make it useless to confine
and isolate patients; in any case, these measures
were non-curative. The second category is comprised
of sedatives or tranquilizers and the third
antidepressives.

200. John Paul II, To the
participants at the International Conference on
Drugs and Alcohol, Nov. 23, 1991, n. 4.

203. This is confirmed by the
frequency and the conviction with which patients
tell the doctor: "Now that I have spoken to you I
feel better." And in fact just as "there is
therapeutic input which physical healing can bring
to the spirit of the patient; inversely, there is a
therapeutic input which can be brought to physical
suffering through psychologico-spiritual
comforting." Paul VI, To the III World Congress
of the International College of Psychosomatic
Medicine, Sept. 18 1975, in AAS 67 (1975) 544.

205. "Considered in its
totality, modern psychology deserves approval from
the moral and religious viewpoint." (Pius XII, To
the members of the XIII International Congress on
Applied Psychology, April 10, 1958, in AAS 50
(1958) p. 274.

208. "Experience teaches that
man, needing either preventative or therapeutic
assistance, reveals needs that go beyond actual
organic pathology. It is not only suitable treatment
that he wants from the doctor-treatment which, in
any case, sooner or later will fatally show itself
to be insufficient-but the human support of a
brother, who can share with him a life view, in
which also the mystery of suffering and death will
make sense. And whence can be had, if not in faith,
this tranquilizing response to the supreme questions
of existence?" (John Paul II, To the World
Congress of Catholic Doctors, Oct. 3, 1982, in
Insegnamenti V/3, p. 675, n. 6).

210. "A unique light shines
from the paschal mystery on the specific task which
pastoral health care is called to fulfill in the
great commitment of evangelization" (John Paul II,
To the plenary assembly of the Pontifical Council
for Pastoral Assistance to Health Care Workers,
Feb. 11, 1992, in Oss. Rom. Feb. 12, 1992, n. 7).
Cf. CCC 1503.

211. In the anxious and
painful state in which he finds himself, the
seriously ill person needs a special grace from God
to keep him from losing heart. There is the danger
that temptation might make his faith waver. For this
very reason, Christ wished to give his sick faithful
the strength and the very real support of the
sacrament of Anointing" (Cong. Div. Worship, Sacrament of Anointing and Pastoral Care of the Sick,
Nov. 17, 1972. Ed. Typica, Vat. Polyglot Press,
1972, p. 81, n. 5). Cf. CCC 1511.

214. "By the grace of this
sacrament the sick person receives the strength and
the gift of uniting himself more closely to Christ's
Passion; in a certain way he is consecrated to bear
fruit by configuration to the Savior's redemptive
Passion" (CCC 1521). The sick who receive this
sacrament, "by freely uniting themselves to the
passion and death of Christ," "contribute to the
good of the people of God" (LG 11). "By celebrating
this sacrament, the Church, in the communion of
saints, intercedes for the benefit of the sick
person, and he, for his part, through the grace of
this sacrament, contributes to the sanctification of
the Church and to the good of all people for whom
the Church suffers and offers herself through Christ
to God the Father" (CCC 1522).

219. "All the baptized who can
receive Holy Communion are obliged to receive
Viaticum. In fact all the faithful, who for any
reason are in danger of death, are bound by precept
to receive Holy Communion, and pastors should take
care that the administration of this sacrament be
not deferred, so that the faithful can benefit from
it while they are still in full possession of their
faculties" (Ibid, n. 27).

221. John Paul II, To the
participants at the International Congress of the
"Omnia Hominis" Association, Aug. 25, 1990, in
Insegnamenti XIII/2, p. 328. "Such a
situation can threaten the already fragile
equilibrium of an individual's personal and family
life, with the result that, on the one hand, the
sick person, despite the help of increasingly
effective medical and social assistance risks
feeling overwhelmed by his or her own frailty; and
on the other hand, those close to the sick person
can be moved by an understandable even if misplaced
compassion" (John Paul II, Encyclical Evangelium
vitae, March 25, 1995, n. 15).

223. Cf. John Paul II, To
the participants at the International Congress on
Assistance to the Dying, in Oss. Rom. March 18,
1992 n. 5.

224. "It is only a human
presence, discreet and caring, which allows the
patient to express himself and to find a human and
spiritual comfort, that will have a tranquilizing
effect" (Pont. Coun. "Cor Unum," Some Ethical
Questions Relating to the Gravely Ill and the Dying,
July 27, 1981, in Enchiridion Vaticanum 7, Documenti ufficiali della Santa Sede 1980-1981.
EDB, Bologna 1985, p. 1151, n. 4.3).

225. Cf. John Paul II, To
the participants at the International Congress on
Assistance to the Dying, in Oss. Rom. March 18,
1992, n. 5.

226. Ibid, n. 1. "'It is in
regard to death that man's condition is most
shrouded in doubt' (GS, 18). In a sense bodily death
is natural, but for faith it is in fact 'the wages
of sin' (Rm. 6:23). For those who die in Christ's
grace it is a participation in the death of the
Lord, so that they can also share his Resurrection"
(CCC 1006; cf. also CCC 1009).

227. John Paul II, To two
work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, in Insegnamenti,
VIII/2, p. 1083, n. 6; cf. To the participants at
the International Congress on Assistance to the
Dying, in Oss. Rom. March 18, 1992, n. 5.

228. John Paul II, To two
work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, in Insegnamenti
VIII/2, p. 1083, n. 6. Cf. CCC 1010. "Death itself
is anything but an event without hope. It is the
door which opens wide on eternity and, for those who
live in Christ, an experience of participation in
the mystery of his death and resurrection" (John
Paul II, Encyclical Evangelium vitae, March
25, 1995, n. 97).

231. Cf. John Paul II, To
the participants at the International Congress on
Assistance to the Dying, in Oss. Rom March 18,
1992, n. 4. Cf. John Paul II, Encyclical Evangelium vitae, March 25, 1995, n. 65.

232. John Paul II, To two
work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, in Insegnamenti
VIII/2, p. 1082, n. 5.

233. "From this point of view,
the use of therapeutic means can sometimes raise
problems": Cong. Doct. Faith, Declaration on
Euthanasia, May 5, 1980, in AAS 72 (1980) p.
549.

234. Cf. John Paul II, To
two work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, in Insegnamenti>VIII/2,
p. 1082. n.5.

236. Cf. Pont. Coun. "Cor
Unum," Some Ethical Questions Relating to the
Gravely Ill and the Dying, July 27, 1981, in Enchiridion Vaticanum, 7,
Documenti ufficiali
della Santa Sede 1980-1981. EDB, Bologna 1985,
p. 1165, n. 7.2; ibid., p. 1143, n. 2.4.1: "Earthly
life is a fundamental but not absolute good. Hence
the limits of the obligation to keep a person alive
must be specified. The distinction-already
outlined-between 'proportionate' means, which must
never be renounced so as not to anticipate or cause
death, and 'disproportionate' means, which can be
and, so as not to fall into therapeutic tyranny,
must be renounced, is a decisive ethical criterion
for specifying these limits.

Here the health care worker finds a meaningful
and reassuring guideline for the solution of the
complex cases entrusted to his responsibility. We
are thinking in particular of states of permanent
and irreversible coma, of tumorous pathologies with
unhappy prognosis, of the aged in grave and terminal
states of life."

237. Cf. John Paul II, To
the participants at the congress of the Italian
Association of Anesthesiology, Oct. 4, 1984, in
Insegnamenti VII/2, p. 749, n. 2; To two
work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, in Insegnamenti
VIII/2, p. 1082, n. 4.

238. For the believer "pain,
especially that of the final moments of life,
assumes a special meaning in God's salvific plan,"
as "a participation in the passion" and "union with
the redemptive sacrifice" of Christ. For this reason
the Christian can be freely induced to accept pain
without alleviation or to moderate the use of
painkillers: cf. Cong. Doct. Faith, Declaration
on Euthanasia, May 5 1980, in AAS 72 (1980) p.
547.

248. Cf. Pius XII, To an
international assembly of doctors and surgeons,
Feb. 24, 1957, in AAS 49 (1957) 145.

249. Cf. Pius XII, To an
international assembly of doctors and surgeons,
Feb. 24, 1957, in AAS 49 (1957) p. 143-146; Cong.
Doct. Faith, Declaration on Euthanasia, May
5, 1980, in AAS 72 (1980) p. 548. "If the patient
obstinately refuses and persists in asking for the
narcosis, the doctor may agree to it without thereby
becoming guilty of formal cooperation in the fault
committed. This, in fact, does not depend on the
narcosis, but on the immoral will of the patient;
whether the analgesic it given to him or not, his
behavior will be identical: he will not do his
duty." (Pius XII, To an international assembly of
doctors and surgeons, Feb. 24, 1957, in AAS 49
[1957] p. 146).

250. Cf Pont. Coun. "Cor
Unum," Some Ethical Questions Relating to the
Gravely Ill and the Dying, in Enchiridion
Vaticanum 7, Documenti ufficiali della Santa
Sede 1980-1981. EDB, Bologna 1985, p. 1159, n.
6.1.1. "Death is the end of man's earthly
pilgrimage, of the time of grace and mercy which God
offers him so as to work out his earthly life in
keeping with the divine plan, and to decide his
ultimate destiny" (CCC 1013).

261. Cf Pius XII, To the
congress of the Italian Catholic Union of
Obstetricians, Oct. 29, 1951, in AAS 43 (1951)
p. 838. "Scripture specifies the prohibition
contained in the fifth commandment: "Do not slay the
innocent and the righteous" (Ex. 23:7). The
deliberate murder of an innocent person is gravely
contrary to the dignity of the human being, to the
golden rule, and to the holiness of the Creator. The
law forbidding it is universally valid: it obliges
each and everyone, always and everywhere" (CCC
2261).

262. Cong. Doct. Faith, Declaration on Euthanasia, May 5, 1980, in AAS
72 (1980) 544-545. "It is unjustified to
discriminate between the different life stages. The
right to life is still intact in an old person, even
if he or she is very debilitated; an incurably ill
person does not lose it. It is no less legitimate in
the newborn child than in the mature person" Cong.
Doct. Faith, Declaration on Procured Abortion,
June 18, 1974, in AAS 66 (1974) 737-738.

264. John Paul II, To the
World Congress of Catholic Doctors, Oct. 3,1982,
in Insegnamenti V/3 671.

265. Cf Cong. Doct Faith, Declaration on Euthanasia, May 5, 1980, in AAS
72 (1980) p. 545: "Everyone has the obligation of
living in conformity with God's plan. Voluntary
death, that is suicide...is a refusal on man's part
to accept God's will and his loving purpose.
Besides, suicide is often a denial of love for
oneself, a rejection of the natural aspiration for
life, a renouncement of one's duties of justice and
charity to one's neighbor, to the various
communities and to society at large, although at
times there may be-as we know-psychological factors
which attenuate or, indeed, take away
responsibility. A clear distinction should be made,
however, between suicide and sacrifice made for a
higher motive-such as God's glory, the salvation of
souls, service to one's neighbor-by which one gives
one's life or puts it in danger" (ibid.).

271. Cf. John Paul II, To
the Association of Italian Catholic Doctors,
Dec. 28, 1978, in Insegnamenti I p. 438 Cong.
Doct. Faith Declaration on Procured Abortion,
June 18,1971, in AAS 66 (1974) 744, n. 24. "Since
the first century the Church has affirmed the moral
evil of every procured abortion. This teaching has
not changed and remains unchangeable. Direct
abortion, that is to say, abortion willed either as
an end or a means, is gravely contrary to the moral
law. 'You shall not kill the embryo by abortion and
shall not cause the newborn to perish' (Didache
2, 2)" [CCC 2271].

277.Code of Canon Law,
can. 1398. Latae sententiae means that the
excommunication need not be pronounced by authority
in every single case. It is incurred by anyone who
procures an abortion by the simple fact of having
voluntarily procured it while aware of the
excommunication.

282. Cf. John Paul II, To
the participants at the III World Congress of the
"International College of Psychosomatic Medicine,"
Sept. 18, 1975. in AAS 67 (1975) 545.

283. Cong. Doct. Faith, Declaration on Euthanasia, May 5, 1980, in AAS
72 (1980) p. 546. Cf. John Paul II, To the
participants at the International Congress on
Assistance to the Dying, in Oss. Rom. March 18,
1992, nn. 3, 5.

284. Cf. John Paul II, To
two work groups set up by the Pontifical Academy of
Sciences, Oct. 21, 1985, n. 3.